MEDICARE: DR. JEFFREY ALAN BRANNEN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	DO-03584	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972616316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY ALAN BRANNEN DO

Provider Business Mailing Address
First Line	:	PO BOX 674721
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75267-4721
Country	:	US
Telephone Number	:	515-643-2519
Fax Number	:	515-222-7601

Provider Business Practice Location Address
First Line	:	1601 NW 114TH ST STE 342
Second Line	:
City	:	CLIVE
State	:	IA
Zip	:	50325-7036
Country	:	US
Telephone Number	:	515-222-7600
Fax Number	:	515-222-7601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	11/23/2025

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